IVINS: Medicare Prescription for Disaster

[Guest guest]

http://www.alternet.org/story.html?StoryID=16246

 

IVINS: Medicare Prescription for Disaster

 

Molly Ivins, AlterNet

June 24, 2003Viewed on June 26, 2003

 

AUSTIN, Texas -- Food fight! Here's a beauty: to vote or not to vote, to favor

or not to favor the Medicare Prescription Drug Bill?

 

Theoretically, everybody's in favor of a plan to help senior citizens with

prescription drug costs, which are truly appalling. Many seniors literally have

to choose between their meds or food. Everyone agrees it's awful -- the question

is whether the bills currently in the House and Senate are actually an

improvement.

 

Those of you who make up your minds based on the if-he's-for-it, I'm-against-it

method (quite a few people seem to be doing that these days) are in deep doo-doo

on this one. True, Ted Kennedy is for it, and The Wall Street Journal is against

it. On the other hand, the White House is for it, and pretty much everyone on

the left except Kennedy is against it. The press is helpfully wringing its hands

and announcing, " This is soooo complicated. "

 

So let's try the unusual maneuver of actually looking at the merits of the

thing. If you put, as Consumer Reports has helpfully done, the hybrid House

Republican/Bush bill up against the Democrats' version by the respected Medicare

expert John Dingell, it's no contest. The Democratic bill is better in every

respect -- except, of course, it costs more. It has the additional flaw of being

unlikely to pass in the Republican House.

 

In fact, the Republicans are not entirely sure they can get their own awful

version passed. For starters, the Republican version covers, at best, 22 percent

of projected prescription drug expenditures. It includes a $250 deductible, 20

percent coinsurance up to $1,000 and 50 percent coinsurance on $1,001 to $2,000,

and costs an extra $35 a month. There's an even weirder hitch called " the

doughnut, " a hole in the middle, that leaves seniors spending between $4,500 and

$5,800 uncovered.

 

Don't even ask how that got in there -- you don't want to know about that bit of

sausage-making.

 

According to CR's calculations, the average Medicare beneficiary now spending

$2,318 for meds would find the out-of-pocket cost under the Republican version

higher in 2007, a total of $2,954 in constant dollars. Under the Senate bill,

CRE estimates the same $2,318 would come to $2,524 in 2007, including premium,

deductible, co-payments and the " doughnut. "

 

" If the growth of prescription drug expenditures moderates below historical

levels to 12 percent a year (and this is unlikely because neither bill includes

sufficient safeguards to hold down drug prices), the average Medicare

beneficiary would still face, under the House bill, out-of-pocket costs in 2007

that are approximately the same as they are now. Under the Senate bill,

out-of-pocket costs would be only marginally lower than those of 2003, "

concludes CR.

 

So here's the politics on the deal. Kennedy is supporting the Senate version

because (A) it's marginally better than what we have now and (B) in one of the

hoariest cliches of political debate, this gets the head of the camel into the

tent. In other words, it's a start, and a better program can be built later --

in fact, it pretty much will have to be. The White House's logic is (A)

Republicans promised a prescription drug benefit and (B) they can pass this in

time for the 2004 election and take credit for it, but it doesn't go into effect

until 2006 (a clever ploy), so no one will have time to figure out it's a fraud.

 

Of course, the Republicans originally wanted to use this as a tool to break down

Medicare completely, insisting on more " private sector " involvement. Bush

initially planned to use the bill to herd seniors into HMOs. Since private

insurance companies refuse to serve seniors in rural areas and have already

dropped 2.4 million seniors in " unprofitable " areas, and since seniors in

private plans are getting hit with soaring premiums and shrinking benefits,

that's a non-starter.

 

The biggest missed opportunity in both House and Senate versions was not using

any tool to rein in drug company profits. (Please note generous contributions by

drug companies to politicians of both parties.) The loopholes that delay the

introduction of generic drugs should be plugged up, and the government should

use its purchasing power to negotiate lower prices.

 

Bottom line, Kennedy's right: The Senate version is incrementally better, and in

politics, you should always take half a loaf, or even 22 percent of a loaf, if

you can get it. But if the Senate version is even slightly weakened by the

repulsive House version, fuhgeddaboutit.

 

 

 

© 2003 Independent Media Institute. All rights reserved.

 

 

 

 

 

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